Dr. Kara Fitzgerald | New Frontiers in Functional Medicine, Longevity, Epigenetics

Harvard scientist and NYT best-selling author David Sinclair, PhD and I take a tour around the science of aging. If aging is THE root cause of all of the chronic diseases of aging, then arguably, if we focus on the aging journey itself, we might be able to stop playing “whack-a-mole medicine.” A lot of complex environmental, genetic, epigenetic and biochemical processes go into the aging journey, however, as Dr. Sinclair discusses, it looks like a very heavy lifter in aging is epigenetic changes – specifically, DNA methylation and demethylation (plus histone acetylation). In this episode of New Frontiers, learn about the amazing research going on at Dr. Sinclair’s lab, hear what’s getting translated to humans, and what you can do NOW to stop the epigenetic clock from ticking…. Listen and learn, leave us a 5 star review if you’d be so kind, and be sure to share with your colleagues! ~DrKF

COVID19 is upon us. Months earlier, we scheduled James Maskell to discuss his recent book: The Community Cure. Amazingly, his message today is all the more urgent. James argues for the group visit model, was an early adopter and proponent of group visits (in fact, we discuss the pre-publication Cleveland Clinic group visit research findings, which are astonishingly good; even better than the first JAMA publication comparing functional medicine one-on-one with family medicine.) Now, with COVID19 and self-isolation, the virtual visit and the virtual group visit (where James saw FxMed eventually going) is upon us. And specifically, his vision is that this model works in insurance – and even Medicare. James’ message – the promise of functional medicine – is timely, inspiring, and essential. ~DrKF

The GI360 is a smart, evidenced-based stool test that is easily actionable by the clinician. Listen to my conversation today with VP of Scientific Support from Doctor’s Data, Dr. David Quig. One of the most useful tools I am aware of in stool testing is the Dysbiosis Test, which identifies and characterizes more than 45 targeted analytes across six Phyla using PCR and compares the patient results to a characterized normobiotic reference population. DDI is also using the Luminex PCR panel for pathogens, parasites and viruses – an FDA cleared panel for accurate detection of microbes that are almost always a problem. But what if they are not? Hear my discussion with Dr. Q on that. Finally, beta glucuronidase – it’s SO MUCH more complex than we’ve understood. Yes, we’re aware of the estrogen connection, but the BG story has evolved. We also walk through the chemistries – DDI includes a wide range of chems (appreciated by me and my colleagues here in our practice). Give us a listen, then leave a 5 star review and comment -- if you would be so kind! Thank you! ~DrKF

What a superb conversation with leading expert lipidologist and – importantly – clinician of 30+ years, Tom Dayspring, MD. In this tour-de-force conversation, we break down the essential cardiovascular risk laboratory analysis you need to be undertaking on all your patients. We spend a little extra time on Lp(a) and the coronary calcium score. Our conversation is practical; I was fervently taking notes through the entire recording, as I suspect you’ll be doing. I will likely bring Tom back for additional conversation, perhaps focusing on women’s cardiovascular health, so stay tuned! As with many of my podcasts, I chat with my guests before and after the recording. Tom and I discuss on the podcast whether we’re concerned about brain cholesterol deficits with an excessively lowered LDL. He unequivocally stated not; we synthesize all the cholesterol we need locally, including in the CNS. However, after the recording, he added that statins can cross the BBB and lower brain cholesterol. Serum desmosterol is an analyte that can readily be assessed that is a surrogate marker of brain cholesterol: consider this if needed. Enjoy this in-depth conversation, and be sure to leave New Frontiers a rating on iTunes or Stitcher or wherever you listen. It’s the best thing you can do to help share this valuable content and help put FxMed in front of more and more listeners! Thank you! ~DrKF

Globally, stress and anxiety levels have never been higher. According to one recent survey, a full 70% of Americans are stressed out, with a disproportionate impact on people of color. From worry about getting sick, to sick family members, to financial pressures, to homeschooling, the list of possible contributing factors is long. How do we care for our patients or clients in this climate? Victoria Albina, NP MPH is a family nurse practitioner in NYC – the COVID epicenter. She’s also a cognitive behavioral life coach and breathwork meditation facilitator. In short, she’s remarkably suited to walk us through tools to consider using with patients immediately. Victoria was an early adopter of using CBD for anxiety and has a wealth of knowledge around how to work with it for acute anxiety (regardless of how it presents: from insomnia to addictive “buffering” behavior). She also covers lifestyle interventions and key botanicals she’ll use concurrently when the need exists. And to top it off, Dr. Albina walks us through a lovely breathing exercise at the end of our conversation. It was one of the most grounding – and informative- podcasts I’ve done 😊, and I can’t wait to hear what you think. Leave us a review and 5-star rating on iTunes or wherever you listen to New Frontiers. Thank you! ~DrKF

Many of us in functional/integrative medicine have used organic acid testing for decades to identify nutrient, toxin, and genetic imbalances. I am proud that the lab I once worked in developed one of the original panels – still quite popular and in wide use today. Inspiration for organic acid testing came from inborn errors of metabolism research, where a handful of compounds are (still) measured in newborns to rule out severe genetic diseases. Flash forward to the “Omics” revolution: you know, the genome, the epigenome, exposome, microbiome, etc. We’re beyond the 42 organic acids of old, and moving closer to clinical metabolomics. For me, it's about time, to be honest. Metabolomics in the research setting has been happening for years, and today I talk with Betsy Redmond, PhD, on the ultimate metabolomic panel for clinicians and what that might look like: actionable, straightforward, and evidence-based. Perfect for the busy clinician, and satisfying for those who want a drill-down into the biochemistry. Thanks for listening, and please leave us a review wherever you listen to New Frontiers! ~DrKF

A nurse wakes in the night in profound anxiety, she can’t breathe, her first panic attack. Her husband is quarantined with COVID19; while she works the frontlines at a large hospital, witnessing what looks like the apocalypse. She begins a series of gentle, EFT Tapping exercises. After three brief rounds, she’s through the panic, able to once again relax. Nick Ortner is the CEO of The Tapping Solution, LLC, and my guest today on NFFM. Tapping is such a simple, elegant, immediate solution to the profound anxiety that comes with the out-of-control stress, fear and economic panic intrinsic in the COVID pandemic. With the Tapping Solution app (full access is available to healthcare providers for free), we can ground ourselves as needed. And for the data hounds among us (yes, that would be me); the app is tracking outcome. Over 1.5 million sessions have been conducted using the app. Regarding COVID19 specific exercises, Nick reports a couple of things: 1. Stress is at an all-time high 2. There is a daily average 45% reduction in the experience of stress after TAP exercises. You will enjoy this in-depth interview with Nick, and takeaway immediate tools to put to use for yourself and your patients. Let me know what you think, and please rate and review wherever you’re listening to New Frontiers.~DrKF

Dr. Alex Vasquez has been teaching clinicians, publishing articles, books, and also edits his own journal – for decades. If you know Alex, you know he’s a bright light – highly regarded in our field. You may also know he’s struggled with a “tough gut” for years; in fact, this is what brought him to integrative medicine. From our years teaching together, I know Dr. V is diligent – profoundly committed, actually – to trying/vetting/evolving integrative protocols for gut health (botanicals, diets, pharma, fiber combinations, gentle, aggressive), often receiving small measure of benefit. He’s used various protocols with his patients, case studies he often generously shares when teaching. But here’s the thing: when Dr. Vasquez says he experimented for a long time on himself, creating and tweaking, over and over, a fiber-centric product that resolved his gut issues, we shut up and listen, do we not? So that’s what this podcast is about: talking about a wonder product, designed primarily by Dr. Alex Vasquez, that will likely revolutionize our approach to treating tough guts (think refractory SIBO, dysbiosis, inflammation, permeability, etc). Furthermore, it looks like this program will balance metabolic irregularities and address weight loss resistance – all very exciting! I had a great conversation with Dr. Vasquez on the origin and design, and science behind this new intervention. I would LOVE to hear how you like it, what kind of results you’re getting, and if you decide to try it on your TOUGH gut patients. Listen and learn from Dr. V, and please share with your colleagues, and leave a review wherever you listen to New Frontiers. ~DrKF

Traditional Chinese Medicine (TCM) is used in all settings in China for COVID19, with preliminary outcome data very, very strong. Indeed, outcome data using TCM for prevention and treatment of SARS Cov1 was equally strong. Listen to one of the most important and timely conversations I’ve had to date on New Frontiers with Dr. John Chen, one of the world’s leading experts in TCM (with western pharma training). Framing TCM in language clear for the Western-trained clinician, and translating the early descriptive language, Dr. Chen (author of the seminal textbooks used in all the TCM training programs in the US) is actively following TCM in China, and shares his experience, insight, and observations with all of us. An incredible, and timely, conversation, worthy of your utmost attention. ~DrKF Dr. Chen, author of the seminal textbooks used in all the TCM training programs in the US is actively following TCM in China

We are all familiar with the Wahls Protocol. But how about the story behind the protocol? Did you know, for instance, that her director at U of Iowa (Terry is a clinician researcher) told her to write up herself as a case report? That was the first step. Her “N of 1”; then she wrote up a case series. Then she received a small grant and product for a slightly larger study. Then a million dollars. And now she’s heading into her largest study to date (yes, you will be able to refer patients). Listen to our New Frontiers conversation on how YOU as an FxMed clinician can contribute to the body of research demonstrating that: What. We. Do. Works. Terry and I also talk about behavioral change as THE MOST Important piece of the change journey. Hear how she supports it. This was by FAR one of my most treasured convos this year, and I appreciate you listening, commenting, giving us a 5-star review pretty please, and sharing with your colleagues! ~DrKF